Asthma Management Handbook
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Table. Reviewing and adjusting preventer treatment for children aged 1–5 years

Treatment trialled Management options at a review after a treatment trial of 4-6 weeks
Good treatment response No or partial treatment response

Inhaled corticosteroid
(low dose)

 

 

Continue regular treatment at low dose

If symptoms remain well controlled ≥6 months, consider stopping treatment and reviewing in within 12 weeks§

 

Review the diagnosis, adherence and inhaler technique

Consider referral to a specialist (e.g. paediatric respiratory physician or paediatrician, if available) for assessment

Consider adding montelukast (in combination with inhaled corticosteroid)

Montelukast (children 2 years and over)

Continue montelukast treatment Stop montelukast and start treatment with an inhaled corticosteroid, starting with a low dose
  • Advise parents/carers about potential adverse behavioural and/or neuropsychiatric effects of montelukast

Treatment response: symptoms well controlled and no treatment-related adverse effects

No or partial treatment response: symptom control not achieved with initial treatment after verifying treatment was taken as intended

§ Timing of review depends on individual child’s trigger factors

‡ PBS status as at March 2019: Montelukast is not subsidised by the PBS for children aged 2–5 years with moderate-to-severe asthma, or when used in combination with another preventer.

Last reviewed version 2.0

Asset ID: 25